Exercise May Help Improve Memory Problems

Reference: ADVANCE for Speech Language Pathologists- March 20,2011   
 
Adults with memory problems who participated in a home-based physical activity program experienced a modest improvement in cognitive function, compared to those who did not participate in the program, according to Australian researchers [JAMA, 300, (9): 1027-1037].

As the world population ages, the number of older adults living with Alzheimer’s disease is estimated to increase from the current 26.6 million to 106.2 million by 2050.  “If illness onset could be delayed by 12 months, 9.2 million fewer cases of Alzheimer’s disease would occur worldwide.  For this reason, attempts have been made to identify individuals who are at increased risk of Alzhiemer’s disease and to test interventions that might delay the progression of prodromal symptoms [early non-specific symptom, or set of symptoms] to full-blown dementia,” the authors wrote.

Nicola T. Lautenschlager, MD, of the University of Melbourne, Australia, and colleagues conducted a randomized controlled trial to test whether a physical activity intervention would reduce the rate of cognitive decline among 138 adults age 50 years and older at increased risk of dementia.  The participants, who reported memory problems but did not meet criteria for dementia, were randomly allocated to an education and usual care group or to a 24-week home-based program of physical activity.

The aim of the intervention was to encourage participants to perform at least 150 minutes of moderate-intensity physical activity per week, which participants were asked to complete in three 50-minute sessions each week.  The most frequently recommended type of activity was walking.  The intervention resulted in 142 minutes more physical activity per week or 20 minutes per day than with usual care.  Cognitive function was assessed with the Alzheimer Disease Asssessment Scale-Cognitive Subscale (ADAS-Cog; a measuring tool that consists of a number of  cognitive tests) over 18 months.

The researchers found that by the study’s end, participants in the exercise group had better ADAS-Cog scores and delayed recall than those in the usual care control group.  Participants in the physical activity group also had lower Clinical Dementia Rating scores than those in the usual care group.

“To our knowledge, this trial is the first to demonstrate that exercise improves cognitive function in older adults with subjective and objective mild cognitive impairment.  The benefits of physical activity were apparent after 6 months and persisted for at least another 12 months after the intervention had been discontinued.  The average improvement of 0.69 points on the ADAS-Cog score compared with the usual care control group at 18 months is small but potentially important when one considers the relatively modest amount of physical activity undertaken by participants in the study,” the authors write.

“Unlike medication, which was found to have no significant effect on mild cognitive impairment at 36 months, physical activity has the advantage of health benefits that are not confined to cognitive function alone, as suggested by findings on depression, quality of life, falls, cardiovascular function, and disability.

Friends with Cognitive Benefits

Reference:  ADVANCE Magazine for Speech Language Pathologists, March 17, 2011

Mental function improves after certain kinds of socializing.

Talking with other people in a friendly way can make it easier to solve common problems, but conversations that are competitive in tone, rather than cooperative, have no cognitive benefits, a recent study shows (Social “Psychological and Personality Science, online, Oct. 13, 2010). 

“This study shows that simply talking to other people, the way you do when you’re making friends, can provide mental benefits”, said lead author Oscar Ybarra, PhD, a psychologist at the Institute for Social Research at the University of Michigan.

Researchers examined the impact of brief episodes of social contact on executive function, a key component of mental activity.  Previously, Dr. Ybarra had found that social interaction provides a short-term boost to executive function that is comparable in size to playing brain games, such as solving crossword puzzles.

In the current series of studies, he and colleagues tested 192 undergraduates to pinpoint which types of social interaction help and which don’t.  They found that engaging in 10-minute conversations in which participants simply were instructed to get to know another person resulted in boosts to subsequent performance on an array of common cognitive tasks.  But when participants engaged in conversations that had a competitive edge, their performance on cognitive tasks showed no improvement.

“We believe that performance boosts come about because some social interactions induce people to try to read others’ minds and take their perspectives on things,” Dr. Ybarra said.  “We also find that when we structure even competitive interactions to have an element of taking the other person’s perspective, or trying to put yourself in the other person’s shoes, there is a boost in executive functioning as a result.”

In addition, the improvement in mental function was limited to tasks assessing executive function.  Neither processing speed nor general knowledge was affected by the type of social interaction engaged in by participants.

“Taken together with earlier research, these findings highlight the connection between social intelligence and general intelligence,” he said.  “This fits with evolutionary perspectives that examine social pressure on the emergence of intelligence and research showing a neural overlap between social-cognitive and executive brain functions.”

The research also has some practical implications for improving performance on certain kinds of intellectual tasks.  If you want to perform your best, having a friendly chat with a colleague before a big presentation or test may be a good strategy.

Blogger comment:  I can attest to having more energy after I have socialized with friends in a noncompetitive way.  It seems to help my frame of mind and I am more productive.  In this high technology world and with emphasis on texting and social media, it is refreshing to know that face to face contact with people is and always will be beneficial to all of us.

Making Kids Safe In Sound

As iPod or MP3 use among children grows at an unprecedented rate fueling concerns that many are using the technology unsafely, the American Speech-Language-Hearing Association’s (ASHA) Listen to Your Buds website (www.listentoyourbuds.org) aims at empowering parents and protecting children from noise-induced hearing loss and other communication difficulties.

Protect your child’s hearing by teaching three basic principles: keeping the volume down, limiting listening time, and watching for warning signs of hearing loss. 

Landmark Study

This is an older article from Jan. 11, 2010, but I found it fascinating.  It is taken from ADVANCE for Speech-Language Pathologists and Audiologists.  I have deleted some of the content due to time restrictions, but have included the main points of the article and the implications of the study. 

This study suggests that verbal apraxia symptoms are part of a larger syndrome.  It reveals that a new syndrome in children presents with a combination of allergy, apraxia and malabsorption.  Autism spectrum disorders were variably present.

Verbal apraxia had been understood to be a neurologically-based speech disorder, although hints of other neurological soft signs had been described.  The recent study suggests the symptoms of verbal apraxia are part of a larger, multifactorial neurologic syndrome involving food allergies, gluten sensitivity and nutritional malabsorption-at least for a subgroup of children.

“While it is critical to treat verbal apraxia symptoms that often include severe delays in expressive speech production with speech therapy, we need to start asking why these kids are having these problems in the first place so we can identify mechanisms we can target to treat the cause of the symptoms,” said Claudia Morris, MD, of Children’s Hospital and Research Center in Oakland, CA.  She conducted the study in conjunction with Marilyn Agin MD, a neurodevelopmental pediatrician at Saint Vincent Medical Center in New York.  The study takes a major step toward identifying the potential mechanisms that may contribute to apraxia symptoms. 

The symptoms that the children demonstrated were a common cluster of allergy, apraxia and malabsorption, along with low muscle tone, poor coordination and sensory integration abnormalities.  The children also revealed low carnitine levels, abnormal celiac panels, gluten sensitivity and vitamin D deficiency, among others. 

The data indicate that the neurologic dysfunction represented in the syndrome overlaps the symptoms of vitamin E
deficiency.  While low vitamin E bioavailability may occur due to a variety of different causes, neurological consequences are similar, regardless of the initiating trigger.

The study suggests that vitamin E could be used as a safe nutritional intervention that may benefit some children.  Growing evidence supports the benefits of omega-3 fatty acid supplementation in a number of neurodevelopmental disorders. 

Anecdotally, children with verbal apraxia often demonstrate leaps in speech production when taking high-quality fish oil.  The addition of vitamin E to omega-3 fatty acid supplementation in this cohort of children induced benefits that exceeded expectations from just speech therapy alone, according to parental report.

“While data from a case series is by no means conclusive, the results clearly point to the need for further attention to this poorly understood disorder and a placebo-controlled study to investigate the potential role of vitamin E and omega-3 supplementation in this group of childreen,” said Dr. Morris.

Children with an apraxia diagnosis also should receive a more comprehensive metabolic evaluation than what is current practice, she pointed out.  Many nutritional deficiencies like low carnitine, zinc and vitamin D are treated easily.  If nutritional deficiencies are not addressed, children will continue to experience significant medical consequences. 

The underlying cause of these deficiences and a fat malabsorption syndrome should be determined after deficiencies are identified and treated.  In the meantime, the new study provides the essential foundation for identification.

“By identifying the early red flags of this syndrome, we have provided a way to get these kids treatment at the earliest possible moment,” she said.  “While 75 percent of the kids identified as late bloomers are just that, the rest have a true pathologic condition.  To miss it is to miss critically valuable time for early intervention.”

Children who have all these symptoms are likely to fall into the 25 percent who have a condition that needs further evaluation and treatment, Dr. Morris stated.

References:
Morris, C.R., Agin, M.C. (2009) Syndrome of allergy, apraxia, and malabsorption: Characterization of a neurodevelopmental phenotype that responds to omega 3 and vitamin e supplementation.  Alternative Therapies in Health and Medicine, 15 (4)

Atladottir, H.O., Pedersen, M.G., Thorsen, P., et al. (2009).  Association of family history of autoimmune diseases and autism spectrum disorders. Pediatrics, 124: 687-94.